Lisa Harbinson wanted a new life insurance policy for her mother, Joyce. She thought mom was paying too much at over $100 a month for a $10,000 term policy that she had borrowed money against and now had to pay back. Obviously, Lisa thought it was also definitely time to look for a more reasonable plan that wasn’t about to expire.

She also began to research the cost of funerals so she could purchase exactly the amount she needed to give her mother a proper send-off, but little did she know at the time, that send-off would come too soon.

The Risk

“Mom had heart surgery on March 27th and they were replacing two valves,” remembers Lisa. “She had cataracts and through the years the doctors kept telling her that they’d keep an eye on it until something was needed, and finally something was needed. She went to the specialist to have it removed, but she had rheumatoid arthritis and was in so much pain that she couldn’t stay absolutely still for the procedure, so we got an anesthesiologist and he discovered a heart murmur.”

Lisa Harbinson (right) and her mother Joyce Barbara Truman (left)

From there, tests were ordered, then an appointment with a cardiologist and more tests in Hamilton, where doctors inadvertently gave her mom some shocking news:

“They said, ‘Well, you know you’re having open heart surgery,’ and we were like, ‘Um… no, what are you talking about?’ They said, ‘Well, your mother probably had rheumatic fever when she was a child,’ and my mom said, ‘I’ve never been told that,’ but that’s when they told us about the damaged valves and our options were she would have a couple more years to live, and they wouldn’t be very good, or she could have the surgery.”

The Preparation

Four years before, Lisa went online and found LSM insurance broker Tamara Humphries, who helped her buy two permanent life insurance policies for her mom from Assumption Life. The first was for $6,500 and then, when they found out from funeral homes that they would need more, another $2,500 policy.

“They didn’t know if they could afford it and you’re better to get a smaller policy that you can afford, rather than a policy that’s going to lapse because you can’t afford it,” says Humphries. “I think originally, they were looking for insurance for Lisa’s husband and then found out about her mother’s former policy. They purchased two permanent policies with guaranteed level premiums, so that they wouldn’t get messed up with term renewals again.”

When she bought the policies, Lisa reports that the care and attention Humphries gave her and her mother couldn’t have been better.

“I’d only dealt with insurance people coming to my home, but me and Tamara did everything online,” says Lisa. “I knew what I was looking for and I knew how much I wanted. She just gave me the list of what I could get via email and everything was sent to me in the mail after we signed everything and filled out all the paperwork, so it was very convenient and straightforward. There was even concern. People said, ‘Are you sure you can get life insurance that way? It’s not safe, and maybe you won’t get paid.'”

“LSM Insurance isn’t a call centre of anonymous people,” says Humphries. “There’s a person that takes the client’s information, generally talks to them, or they email back and forth. Then that client is assigned a broker who can best answer their questions and that broker has the relationship with the client. If Lisa had wanted to meet face-to-face, we could have done so.”

“I just thought it must be okay. I mean I talked to the lady and made phone calls with her as well, so I knew everything was on the up and up,” confirms Lisa.

The Bad News

Tamara Humphries stood in the gap for Lisa when it was needed most.

Good thing it was, because Lisa would be making a claim as the beneficiary on her mother’s policy much sooner than she ever anticipated.

Her mother elected to have the open heart surgery but unfortunately never recovered.

“She just didn’t get strong enough from it. She just kept getting fluid in her lungs and they couldn’t get her better, so she just passed away,” laments Lisa. To this day she still doesn’t know what the actual cause of her mother’s death was and wants to get to the bottom of it.

Collecting on her mom’s two life insurance policies wasn’t without its challenges, but thankfully Humphries helped Lisa every step of the way. “It was actually the funeral home that initiated the claims process because there was confusion there because they wanted the money sent to them and I said okay because I’d never been an executor before, so I just thought that was the process.”

It wasn’t until Humphries stepped in to put a stop to that and told Lisa that the payout could go to no one other than Lisa herself that she realized she might have been taken advantage of. “I would’ve never known,” says Lisa. “I actually called other funeral homes and asked if they ask for a deposit or insurance cheques to be signed over and they said, ‘No, we don’t ask for any of that. We get paid when the insurance company pays out.’ Tamara really guided me along which avenues to go through.”

Humphries also kept up the communication over the years with both Lisa and her mother. So, when it was time to claim on the policies, it was like she never left. “I was shocked, but when everyone else was on vacation over the summer Tamara gave me the number to her cottage just to be available if I needed her,” says Lisa.

It turned out she would need her sooner rather than later because, just as the funeral bill arrived, the $2,500 policy was denied.”They said mom had cancer when she signed the papers and I said, ‘No, no, no she didn’t!’ So, we had to go to my mom’s family doctor and ask him what happened and he looked at the paperwork and said, ‘She had that little skin cancer on her neck that she had removed,’ and I said, ‘Yeah, but we never heard it was cancer. We just assumed no news was good news. He said, ‘Yeah, but you can’t fight with insurance companies once they make up their mind,’ so I let it go.”

The Good News

Once again, Humphries was there to step into the gap and remind Lisa she had a case to challenge the decision, but it took her own persistent follow-up to even find out there was a problem at all.

“I have to say first that Assumption Life was a real stand-up company. A lot of companies wouldn’t have reversed the decision and honored the claim,” says Humphries. “What happened was, you have to disclose all your medical information accurately and Joyce answered no to all of the questions. However, she should have answered yes to one of the questions, but she was not aware that the answer should’ve been yes. The doctor’s office did not tell her the results of the exploratory procedure that she had.”

The first policy was five years old, so it was paid without a problem, but the second claim was launched under two years from the purchase of the policy and investigations are customary for all policies when the insured dies within the first two years of having one. So the insurance company refunded the premiums with interest and decided not to honour the claim because the truthful answer to the particular question should have been yes. Still, the fight was not over yet. Applicants only sign the paperwork to say they’ve filled out the information to the best of their knowledge and at the time, Joyce had done just that.

“All I said to Lisa was, ‘Look, this is not a problem because all you need to get the doctor to do is confirm that their office didn’t tell you the results and you can reopen the case,’ because all the insurance company knows is the person lied on the application. They have no other information,'” explains Humphries.

The Reversal

The decision was eventually reversed and Lisa had never been more relieved after not knowing that insurance company decisions can be challenged.

“Once you’re denied, I just assumed that you’re denied, and I think a lot of people do,” says Lisa. “Without Tamara, I never would’ve challenged it. She’s a lifesaver. We were just blown away by Tamara.”

“I always thought insurance brokers were self-interested and working for the interest of the insurance company, but Tamara took every step. I honestly don’t know how we would’ve been able to afford the funeral without the help of the policies she recommended,” she says.

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What Clients Say About LSM

Kumar Sinniah

We got talking to Aman while looking for life insurance. We wanted a detailed insight to the several options available to us. We found Aman very knowledgeable in the subject of insurance. As a broker he could explain the various products and plans to us.

More importantly, he also explained the entire process of getting insurance and underwriting to us. He is not pushy or in a hurry to sell anything. He focused on our needs and hence gave us a sense of comfort. We found him very friendly and well conversant. His knowledge and personality would encourage me to refer him to the people I know looking at life and health insurance options.

Hi Michael in that specific case the term plan was an old term 100 with cash values. The cash values had been borrowed against and the interest on the loan had accumulated to the point that it was destroying the death benefit. It became less expensive to simply purchase a new policy which had no loans against it.

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5 years ago

Michael

If she was paying too much for $10,000 worth of term, wasn’t it more expensive for her to buy the $9000 worth of whole life?

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5 years ago

Isabel

Can you help me out with my brother’s life insurance claim. It’s been 6 months and …. is refusing to pay.